Exacerbation vs Aggravation in Workers’ Comp Claims

Personal Injury Lawyers / Workers Compensation Lawyer / Exacerbation vs Aggravation in Workers’ Comp Claims

When you’ve been hurt on the job, your goal is to get better, not only so you don’t hurt anymore but so you can get back to work. While managing your case, you may see unfamiliar medical terms on your doctor’s reports, and wonder what they mean. An example is exacerbation vs. aggravation in workers’ comp claims. Sometimes used interchangeably, these terms apply to why a work incident has made your pre-existing condition worse. Whether your work duties exacerbated or aggravated your condition, you are entitled to seek compensation and benefits so you can recover. Read on to learn from a Pennsylvania workers’ compensation lawyer from Munley Law about what separates these descriptions and how they may affect your claim. 

What Is Exacerbation and What Is Aggravation?

The Pennsylvania Department of Labor and Industry states that employers must accept an employee “as is” with any pre-existing medical conditions. When the worker’s job makes those conditions worse, the employee can file for workers’ compensation to address care costs and lost income while they recover.

Exacerbating a pre-existing condition causes a temporary increase in the symptoms. In the case of an exacerbated condition, you can return to your original state with treatment. When your work duties or some incident on the job aggravate your pre-existing condition, however, your illness gets worse faster than it would have normally, without the ability to get better.

Suppose you have asthma that you control with an inhaler or oral medication, but you suffer exposure to fumes that cause additional respiratory damage. If the exposure exacerbates your condition, you can recover within a reasonable amount of time and don’t need more medication after recovery. If it aggravates your asthma, on the other hand, you may develop more serious and limiting symptoms earlier than if you hadn’t been exposed on the job. 

How Do You Determine Whether a Job Exacerbated or Aggravated Your Condition?

When we say it takes time, we mean that literally. In most instances, if your condition gets worse due to a work incident, it’s difficult for your doctor to determine if the situation is temporary or permanent until a few weeks have passed. In some cases, such as a heart attack when you had a pre-existing cardiac condition, it may be much clearer that the incident made your health much worse, or aggravated it.

One of the key factors when filing a claim of aggravation of a pre-existing condition or injury is providing medical evidence showing your health status before the incident that made it worse. Your workers’ comp case manager will review these materials closely to verify how much of your medical care is associated with the new damage versus before your accident.  

Your workers’ compensation lawyer can advise and assist you in collecting medical records, reports from physical therapists, and testimony from your healthcare professionals. They can manage this on your behalf, as well as communicate with the workers’ comp insurance company, so you can focus on your physical recovery. 

How Do Time Limits Affect Your Claim?

Be aware of the time limits in Pennsylvania for reporting your claim when an incident aggravates your pre-existing condition. You’re not eligible for workers’ comp benefits until you report your injury, which is sometimes as quickly as within 21 days but may be longer depending on your case. Another factor is when your doctor determines that your work activities aggravated your condition.

Because state reporting requirements can be confusing, you should review your employer’s insurance policy and consult with an attorney. They can explain the laws and regulations regarding pre-existing conditions in workers’ compensation claims.

How Does Aggravation or Exacerbation Affect the Value of Your Claim?

If your work duties or an accident exacerbate your pre-existing condition, you’re entitled to partial income and coverage for your medical costs. The same is true for an aggravated condition, but your claim is likely to be higher since there is permanent damage that more significantly affects your health. This may also cause the insurance reviewers to examine your claim more closely. 

Insurance companies aren’t fond of paying more than necessary, yet you deserve coverage for how you’ve been hurt. By working with a skilled attorney, you can avoid the stress of these complicated conversations and prepare the materials needed to demonstrate the extent of your harm. Through photos, medical records, and testimony from medical experts, you can build a stronger claim to get the financial relief you need. 

Why Should You Avoid Unintentionally Making Your Condition Worse?

For any workers’ compensation claim, you must be sure to follow your doctor’s orders and refrain from doing anything that might slow or reverse your healing. When you are trying to establish that your duties exacerbated or aggravated your pre-existing condition, this is even more important. The case manager and insurance provider will be on the lookout for any activities that may allow them to reduce your benefits.

For example, if you had a back injury before starting your job and suffered severe pain from lifting a box. Your doctor will likely advise you to avoid actions like lifting, sweeping, climbing, or other tasks that might make the injury worse. If you insist on putting up holiday decorations, you could inadvertently suffer more damage, which the insurance company may use to deny your claim.

For your own sake and health, you should take it easy and focus on getting better. Under the Pennsylvania Workers’ Compensation Act, you are entitled to choose your own doctor in most cases and receive medication, prosthetic devices, supplies, hospital care, and orthopedic appliances to treat your condition. Take the time you need to heal so you don’t turn an exacerbation into an aggravation.

We Are Here to Help You Make the Most of Your PA Worker’s Comp Claim

At Munley Law, our team of attorneys is highly qualified and accomplished, with national recognition among professional legal associations. Yet we’re most proud of how we handle every case: with compassion, honesty, integrity, and dedication. Use our online form to contact us today and schedule a free consultation to learn more about handling your workers’ compensation claim in Pennsylvania.